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Sugar-sweetened beverage consumption and incident hypertension: a systematic review and meta-analysis of prospective cohorts.
Am J Clin Nutr. 2015 Oct; 102(4):914-21.AJ

Abstract

BACKGROUND

The role of sugar-sweetened beverages (SSBs) that contain free or bound fructose in the pathogenesis of hypertension remains unclear.

OBJECTIVE

We conducted a systematic review and meta-analysis of prospective cohort studies to quantify the association between fructose-containing SSBs and risk of hypertension.

DESIGN

MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane registry were searched from conception through 11 November 2014. Two independent reviewers extracted data and assessed the quality of studies (with the use of the Newcastle-Ottawa Scale). Risk estimates of extreme quantiles of SSB intake (lowest compared with highest) for hypertension incidence were generated with the use of generic inverse-variance methods with random-effects models and expressed as risk ratios with 95% CIs. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I(2) statistic.

RESULTS

Six prospective cohort studies (n = 240,508) with 79,251 cases of hypertension observed over ≥3,197,528 person-years of follow-up were included. SSB consumption significantly increased the risk of developing hypertension by 12% (risk ratio: 1.12; 95% CI: 1.06, 1.17) with evidence of significant heterogeneity (I(2) = 62%, P = 0.02) when highest [≥1 serving (6.7, 8, or 12 oz)/d] and lowest (none) quantiles of intake were compared. With the use of a dose-response analysis, a significant 8.2% increase in risk of every additional SSB per day from none to ≥1 SSB/d (β = 0.0027, P < 0.001) was identified. Limitations include unexplained heterogeneity and residual confounding. The results may also have been subject to collinearity effects from aspects of a Western dietary pattern.

CONCLUSIONS

SSBs were associated with a modest risk of developing hypertension in 6 cohorts. There is a need for high-quality randomized trials to assess the role of SSBs in the development of hypertension and its complications. This study was registered at clinicaltrials.gov as NCT01608620.

Authors+Show Affiliations

Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, Departments of Nutritional Sciences and.Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, Departments of Clinical Epidemiology & Biostatistics and.Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, Departments of Clinical Epidemiology & Biostatistics and.Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, Departments of Nutritional Sciences and.Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, Departments of Nutritional Sciences and.Departments of Nutritional Sciences and Heart and Stroke Foundation of Ontario, Toronto, Canada; and American Heart Association, Dallas, TX.Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center.Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, Division of Endocrinology and Metabolism, and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Departments of Nutritional Sciences and Medicine, Faculty of Medicine, University of Toronto, Ontario, Canada;Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, Division of Endocrinology and Metabolism, and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Departments of Nutritional Sciences and Medicine, Faculty of Medicine, University of Toronto, Ontario, Canada;Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada;Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, Departments of Nutritional Sciences and Medicine, Faculty of Medicine, University of Toronto, Ontario, Canada;Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, Division of Endocrinology and Metabolism, and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Departments of Nutritional Sciences and Medicine, Faculty of Medicine, University of Toronto, Ontario, Canada;Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, Division of Endocrinology and Metabolism, and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Departments of Nutritional Sciences and Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada; john.sievenpiper@utoronto.ca.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

26269365

Citation

Jayalath, Viranda H., et al. "Sugar-sweetened Beverage Consumption and Incident Hypertension: a Systematic Review and Meta-analysis of Prospective Cohorts." The American Journal of Clinical Nutrition, vol. 102, no. 4, 2015, pp. 914-21.
Jayalath VH, de Souza RJ, Ha V, et al. Sugar-sweetened beverage consumption and incident hypertension: a systematic review and meta-analysis of prospective cohorts. Am J Clin Nutr. 2015;102(4):914-21.
Jayalath, V. H., de Souza, R. J., Ha, V., Mirrahimi, A., Blanco-Mejia, S., Di Buono, M., Jenkins, A. L., Leiter, L. A., Wolever, T. M., Beyene, J., Kendall, C. W., Jenkins, D. J., & Sievenpiper, J. L. (2015). Sugar-sweetened beverage consumption and incident hypertension: a systematic review and meta-analysis of prospective cohorts. The American Journal of Clinical Nutrition, 102(4), 914-21. https://doi.org/10.3945/ajcn.115.107243
Jayalath VH, et al. Sugar-sweetened Beverage Consumption and Incident Hypertension: a Systematic Review and Meta-analysis of Prospective Cohorts. Am J Clin Nutr. 2015;102(4):914-21. PubMed PMID: 26269365.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sugar-sweetened beverage consumption and incident hypertension: a systematic review and meta-analysis of prospective cohorts. AU - Jayalath,Viranda H, AU - de Souza,Russell J, AU - Ha,Vanessa, AU - Mirrahimi,Arash, AU - Blanco-Mejia,Sonia, AU - Di Buono,Marco, AU - Jenkins,Alexandra L, AU - Leiter,Lawrence A, AU - Wolever,Thomas Ms, AU - Beyene,Joseph, AU - Kendall,Cyril Wc, AU - Jenkins,David Ja, AU - Sievenpiper,John L, Y1 - 2015/08/12/ PY - 2015/01/13/received PY - 2015/07/21/accepted PY - 2015/8/14/entrez PY - 2015/8/14/pubmed PY - 2016/1/6/medline KW - hypertension KW - meta-analysis KW - prospective cohort KW - sugar-sweetened beverage KW - sugars SP - 914 EP - 21 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 102 IS - 4 N2 - BACKGROUND: The role of sugar-sweetened beverages (SSBs) that contain free or bound fructose in the pathogenesis of hypertension remains unclear. OBJECTIVE: We conducted a systematic review and meta-analysis of prospective cohort studies to quantify the association between fructose-containing SSBs and risk of hypertension. DESIGN: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane registry were searched from conception through 11 November 2014. Two independent reviewers extracted data and assessed the quality of studies (with the use of the Newcastle-Ottawa Scale). Risk estimates of extreme quantiles of SSB intake (lowest compared with highest) for hypertension incidence were generated with the use of generic inverse-variance methods with random-effects models and expressed as risk ratios with 95% CIs. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I(2) statistic. RESULTS: Six prospective cohort studies (n = 240,508) with 79,251 cases of hypertension observed over ≥3,197,528 person-years of follow-up were included. SSB consumption significantly increased the risk of developing hypertension by 12% (risk ratio: 1.12; 95% CI: 1.06, 1.17) with evidence of significant heterogeneity (I(2) = 62%, P = 0.02) when highest [≥1 serving (6.7, 8, or 12 oz)/d] and lowest (none) quantiles of intake were compared. With the use of a dose-response analysis, a significant 8.2% increase in risk of every additional SSB per day from none to ≥1 SSB/d (β = 0.0027, P < 0.001) was identified. Limitations include unexplained heterogeneity and residual confounding. The results may also have been subject to collinearity effects from aspects of a Western dietary pattern. CONCLUSIONS: SSBs were associated with a modest risk of developing hypertension in 6 cohorts. There is a need for high-quality randomized trials to assess the role of SSBs in the development of hypertension and its complications. This study was registered at clinicaltrials.gov as NCT01608620. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26269365/Sugar_sweetened_beverage_consumption_and_incident_hypertension:_a_systematic_review_and_meta_analysis_of_prospective_cohorts_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.107243 DB - PRIME DP - Unbound Medicine ER -